The long term goal of this SCOR focusing in the Adult Respiratory Distress Syndrome is to design and test interventions which prevent or ameliorate the disease process or limit its physiological effects. We plan to approach this goal by performing multidisciplinary research to achieve three objectives: 1) to elucidate the mechanisms of inflammation leading to ARDS lung injury; 2) to understand the response of the acutely injured lungs to changes in physiological and therapeutic variables; and 3) to predict ARDS occurrence and course. The approach is multi-disciplinary with investigators trained in medicine, surgery, physiology, anesthesiology, pathology, molecular and cellualr immunology and biology, and biostatistics. This SCOR proposal is the result of a long interest in ARDS by the investigators and a history of collaboration by these investigators. Particular strengths of this proposal include the degree of collaboration and the breadth of disciplines involved, collaboration between clinical and basic science investigators, the investigators' experience with several well characterized animal models of lung injury and experimental preparations, the availability of several unusual or unique experimental techniques, access to ARDS patient populations including some with unique features, and an ability to correlate animal model work with human findings.